独立慈善の患者支援プログラムにおける財政的適格性基準と医療保険
So-Yeon Kang1, Aditi Sen1, Ge Bai1,2
1Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
JAMA
|August 7, 2019
まとめ
独立したチャリティー患者支援プログラムは,主に共同支払いのサポートを提供し,しばしば保険のない個人を除外します. 対象薬は通常,これらのプログラムでカバーされていない薬よりも高価です.
科学分野:
- 健康 経済
- 医薬品政策
背景:
- 独立した慈善患者支援プログラム (PAP) は,高額な処方薬の患者へのアクセスを改善することを目的としています.
- 最近の連邦政府の調査は 薬剤費の増加と 潜在的な反逆法違反の役割に疑問を投げかけています
- これらのPAPの設計,患者の適格性,薬の適用に関する情報は限られている.
研究 の 目的:
- 独立した慈善 PAP の適格性基準と薬物対策を検証する.
- 援助の種類,保険,収入の適格性など,PPPの特徴を分析する.
- 対象と対象でない薬のコストを比較し,高価な非特許ブランド薬のコストを比較する.
主な方法:
- 記述的横断的な研究では,2018年に6つの大きな独立した慈善団体から274のPAPを分析しました.
- 対象となった患者はメディケア受給者だけではありませんでした.
- 分析された薬剤には,メディケア・パートDの支出ダッシュボードと高コストの非特許ブランド薬が含まれています.
主要な成果:
- ほとんどのPAP (61%) は共同支払いの支援のみを提供し,保険のない患者を除いては97%が保険を必要とした.
- がん関連薬は最も頻繁に取り上げられた治療分野でした.
- 対象となる薬の年間平均費用は1157ドルで,対象でない薬の費用 (367ドル) よりも大幅に高かった.
- 高価な非特許ブランド薬は,ジェネリック薬よりも多くのPAPでカバーされました.
結論:
- ほとんどの独立したチャリティーPAPは 保険のない患者を対象にしていません
- PAPは,カバーされていないものと比較して,より高価な薬をカバーする傾向があります.
- PAPが製薬費と遵守に与える影響について,さらなる調査が必要であることを強調しています.
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